TOPIC: Prostate Cancer

WHAT'S THE PROBLEM?

Prostate cancer is the second most common cancer among men in the United States. An estimated 232,090 cases of prostate cancer will be diagnosed in the United States in 2005, causing an estimated 30,350 deaths. Cancer of the prostate is primarily a disease of older men and tends to grow more slowly than other types of cancers. A man may have cancerous prostate cells for many years before developing symptoms or may never develop symptoms at all. Additionally, a large majority – 70 percent – of all cases of prostate cancer are diagnosed in men age 65 or older. Since some older men may already have serious health problems, the majority of men diagnosed with prostate cancer die from causes unrelated to their cancer.

A man’s prostate may become enlarged for many reasons, including an infection of the prostate (prostatitis), a non-cancerous enlargement of the prostate (benign prostatic hyperplasia, or BPH) or prostate cancer. Prostatitis is usually treated with antibiotics or other medications, while BPH may be treated through medications or surgery. Neither condition increases a man’s risk for prostate cancer, although the symptoms – more frequent urination during the day or night and a burning or painful feeling during urination – may be similar.

WHO IS AT RISK?

The factors linked most strongly to a man’s risk for prostate cancer are his age, his family history, and his ethnicity. Older men – particularly those 50 years and older – have a higher risk for prostate cancer. African-Americans have the highest rates of prostate cancer, followed by whites, Hispanics, Asian/Pacific Islanders and Native Americans. Additionally, African-American men tend to develop more aggressive forms of prostate cancer at a younger age, and they have the highest mortality rates for the disease. Finally, an individual’s genetics and family history may influence his risk for the disease. A man whose father, brother or son has been diagnosed with prostate cancer has two to three times the risk of someone with no family history of prostate cancer. That risk increases if the relative was diagnosed at a relatively young age.

Research also suggests that a diet high in fat, especially fat derived from animal sources, may increase the risk of developing prostate cancer. Obesity and smoking have likewise been identified as possible risk factors.

CAN IT BE PREVENTED?

Currently, researchers are investigating whether certain substances may work to reduce prostate cancer risk. Recent evidence suggests that in addition to certain drugs, some compounds, such as vitamins D and E and selenium, may help prevent prostate cancer. In fact, the National Cancer Institute is sponsoring a prostate cancer prevention trial, SELECT, to investigate whether selenium and vitamin E, alone or in combination, may help prevent prostate cancer.

THE BOTTOM LINE

• Prostate cancer is the second most common cancer in men and the number one cancer killer in men.
• Every man is at risk for prostate cancer.
• Risk for prostate cancer increases with age.
• Other, non-cancerous conditions may cause symptoms similar to prostate cancer.
• Screening tests are available for prostate cancer, although their results may not be conclusive.
• Treatment for prostate cancer varies depending upon the age and general health of the patient and whether the cancer has spread to other parts of the body.

CASE EXAMPLES

Sam is a 50-year-old African-American businessman whose father was diagnosed with prostate cancer in his 80s. He thinks he is too young to develop prostate cancer, but he’s recently noticed that he needs to urinate frequently and feels pain while urinating. Sam worries that he may have prostate cancer and consults his doctor, who diagnoses him with prostatitis, a treatable infection of the prostate gland. He speaks with his doctor about his family history and determines that his risk for prostate cancer is only slightly elevated, since his father was diagnosed at such a late age. Because he has a personal connection to the disease and is looking for a way to help, Sam decides to enroll in a clinical trial that is investigating whether vitamin E and other compounds can help prevent prostate cancer.

Zachary is an active 75-year-old who lives with his wife in a retirement community. He had a heart attack in his fifties, and since then has struggled to lower his high cholesterol and blood pressure. Zachary’s wife notices that he gets up frequently during the night to urinate and suggests that he go see a doctor. Zachary agrees to see a urologist and, after a series of tests, is diagnosed with early stage prostate cancer. Since his cancer is localized and slow-growing, his doctor suggests it be treated with “watchful waiting,” in which his tumor will be carefully monitored but not aggressively treated. Zachary agrees, relieved that his cancer does not need immediate intervention but mindful that he needs to watch for increasing or new symptoms.

FOR MORE INFORMATION:

Cancer Information Service
1-800-4-CANCER
www.cancer.gov

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